What this ADHD test measures
This test uses the six-question screener from the Adult ADHD Self-Report Scale, version 1.1 (ASRS v1.1). It asks how often you have felt and behaved in certain ways over the past six months, and it is intended for people aged 18 or over [6].
The six questions ask how often you:
- have trouble wrapping up the final details of a project once the hard parts are done
- find it hard to get things in order for a task that needs planning
- have problems remembering appointments or obligations
- avoid or delay starting a task that needs a lot of thought
- fidget or squirm when you have to sit down for a long time
- feel overly active and driven to do things, as if by a motor
The full ASRS has 18 questions about adult ADHD symptoms. The six in the screener were picked because, together, they matched clinical ratings most closely [1].
Who developed it
The ASRS was developed by a World Health Organization work group [4]. Ronald Kessler and colleagues published the screener in 2005 [1].
The screener is free to use. Its authors ask that the response options, the scoring and the shading are not changed when it is reproduced [5].
How the ASRS screener is scored
Each question has five answers. This page uses the scoring update the authors posted in February 2024 [3]:
| Answer | Points |
|---|---|
| Never | 0 |
| Rarely | 1 |
| Sometimes | 2 |
| Often | 3 |
| Very often | 4 |
The six answers add up to a total from 0 to 24, and a total of 14 or more screens positive [3]. The update sorts totals into four ranges [3]:
| Total score | Range |
|---|---|
| 0-9 | Low negative |
| 10-13 | High negative |
| 14-17 | Low positive |
| 18-24 | High positive |
The original shaded-box rule
The printed form uses a simpler rule. Some answer boxes are darkly shaded, and four or more answers in shaded boxes means your symptoms may be consistent with adult ADHD [6]. The authors explain that this 0 to 6 rule was made to be quick to use in clinics, but it gave high and inconsistent estimates of how common ADHD is. The 0 to 24 method was found to be more robust [3].
What your result can and cannot tell you
A positive screen means your answers look like those of adults with ADHD. It is not a diagnosis. The authors call the ASRS a screening scale, not a diagnostic test, and say anyone who screens positive needs an assessment by a trained clinician [4].
NICE says ADHD should only be diagnosed by a specialist psychiatrist or another appropriately qualified professional, after a full clinical and psychosocial assessment that includes your developmental and psychiatric history [8]. A diagnosis should not rest on rating scales alone [8]. Six questions about the last six months cannot cover:
- Childhood. ADHD symptoms usually start before the age of 12, and a specialist will ask about the history of your symptoms, particularly whether they started in childhood [7].
- Impact. For a diagnosis, symptoms should cause at least moderate problems and happen in two or more important settings, such as home, work or social life [8].
- Other explanations. A GP may also consider other conditions, such as autism or anxiety [7].
How accurate is it?
In the first study, the screener was compared with blind clinical ratings in 154 adults, with extra people included who had reported childhood ADHD [1]. Using the original scoring, it had a sensitivity of 68.7% and a specificity of 99.5% [1]. It rarely flagged people without ADHD, but missed about three in ten people who had it.
A 2007 study of 668 members of a large health plan found strong agreement with clinician diagnoses, with an area under the curve of 0.90 [2].
The authors' calibration rules come from the United States and may not hold in other countries [4]. A low score does not rule ADHD out.
What to do next in the UK
- If you scored 14 or more, or you are worried whatever the number, make an appointment with your GP. The GP will ask about your symptoms and how they affect your life, and may refer you for an assessment with a mental health professional who specialises in ADHD [7].
- Take notes to the appointment. Bring your answers and a few examples from work and home life. The specialist may want to speak to someone who knows you well, such as a family member or close friend [7].
- Expect a wait. Waiting times vary and can run to several months or years [7]. In England, your GP may be able to help you find a clinic with shorter waiting times through the Right to Choose scheme [7].
- In Northern Ireland, mental health assessments usually begin with your GP, who may treat you directly or refer you to mental health services [9].
If you need help now
- If your life or someone else's is at risk, or you cannot keep yourself safe, call 999 or go to A&E [10].
- England: call 111 and select the mental health option [10].
- Scotland: phone NHS 24 on 111 and choose the mental health option [11].
- Wales: call 111 and press option 2. It is free and open 24 hours a day, 7 days a week, for all ages [12].
- Northern Ireland: call Lifeline on 0808 808 8000. It is free and open 24 hours every day [13].
- Anywhere in the UK: call Samaritans free on 116 123, day or night [14], or text the word SHOUT to 85258 for free text support at any time [15].